Provider Demographics
NPI:1942827605
Name:MORELL, ROBERTA H (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:H
Last Name:MORELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:H
Other - Last Name:MORELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1910 DWIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIAL BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:22443-1522
Mailing Address - Country:US
Mailing Address - Phone:703-309-9469
Mailing Address - Fax:
Practice Address - Street 1:9846 LORI RD STE 201
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6695
Practice Address - Country:US
Practice Address - Phone:703-309-9469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904004656OtherVIRGINIA DEPARTMENT OF HEALTHCARE PROFESSIONALS